Individual
STEPHANIE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 120, NEW LONDON, CT 06320-0120
(860) 437-4550
Mailing address
PO BOX 120, NEW LONDON, CT 06320-0120
(860) 437-4550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/01/2009
Last updated
02/10/2025
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